New Tafo Akyem is a town in the east of Ghana. It is a 2.5-hour drive north from the capital, Accra, along a single-lane highway that becomes progressively more potholed until it disintegrates completely into rough stone and ridges. Everything is coated in a thick layer of red dirt.
The district hospital is a rare concrete building: a complex of single-story clinics clustered around courtyards patrolled by chickens. A paved area serves as the waiting room for a routine-vaccination clinic. Here, mothers and babies swelter quietly in the thick, humid air on wooden benches. Community nurse Gladys Dede Tetteh and her team administer protective scratches into tiny thighs, but they have run out of yellow fever vaccines. They expected 35 babies, but 41 have turned up, including a pair of twins.
Vaccines have a limited shelf life and must be kept in dry, temperature-controlled conditions, so it is wasteful to over-order. But Tetteh knows that if she turns away these women, many of whom have walked some distance to get here, there is a chance that they won’t return, and the opportunity to protect their children will be missed. She pulls out her phone and sends a toll-free text message requesting six extra vaccines.
Fifteen minutes later, Tetteh’s phone pings, and I follow her to a grass courtyard, just big enough to park a couple of cars and crisscrossed above by electrical cables. High in the sky, the shimmering cross of a toylike aircraft is already visible. It approaches us silently, looping in a figure-eight pattern, like a hawk eyeing its prey.
Suddenly it sweeps over us and, as it crosses the grass patch, flaps its underbelly open to release a box that floats down under a wax-paper parachute. By the time the package lands, the drone is already on its way back to base, its mission accomplished. The nurses unwrap the protective insulation around the glass vials, and within minutes, another pudgy thigh is vaccinated; another baby is squealing.
“It is so good to get the medicines we need while the patient is still here waiting,” Tetteh says. “It will be so useful for emergencies and to make sure every mother and child is protected.”
It was the promise of meaningful impact that persuaded Gavi, the global vaccine alliance, to support the drone delivery service, funding the capital costs in partnership with the social arm of delivery giant UPS, the Bill & Melinda Gates Foundation, and Pfizer. Moz Siddiqui, who heads innovation at Gavi, explains: “We set a target in 2015 to vaccinate an additional 300 million children by 2020, and we have achieved 86% of this, but the last 14% are the hardest to reach—they live in remote areas, urban slums, or their parents are too burdened to follow up with repeat doses. We’re hoping that drone delivery will help close this gap.”
Anthony Nsiah-Asare, director general of Ghana Health Service, tells me that drones provide a cheaper, more efficient, and more reliable way of delivering just-in-time medical supplies to rural, remote, or nomadic communities than traditional transport systems do.
He and the Ghanaian president first saw a test run of the system in small, mountainous Rwanda in 2016, and they were immediately seduced by this simple way of leapfrogging Africa’s intractable infrastructure. Just as cellphone technology has enabled regions without landline connection to communicate, so “people with bad roads, flooding, and other infrastructure problems will receive drugs they need,” Nsiah-Asare says.
His enthusiasm was instrumental in helping propel the project forward, working with California startup Zipline to create what is now the world’s largest drone delivery program.
The Ghanaian government launched the service on April 24 as part of its integrated health-care system, paying by subscription for deliveries. As far as Nsiah-Asare is concerned, the endeavor proved itself on its first day of operations, delivering life-saving blood to an injured man, insulin to a patient in ketosis, and magnesium sulfate for a woman in labor who had dangerously high blood pressure.
The drones operate out of hubs, the first of which opened this week—a shiny building set into a clearing in the forested hills of Omenako. It will soon be joined by three more hubs, with another two expected by the end of the year. It has a climate-controlled warehouse for storing medicine and emergency supplies, as well as a drone launch and operational facility. By the end of the year, the aim is for six regional hubs providing drone-delivery coverage for the entire nation.
The service has not been without its critics, however. Some have complained that the money would be better spent on traditional services such as more ambulances, for example. But the government is spending less on the drone service than it does on bike and truck deliveries—and it says the drones are more efficient.
Biotech entrepreneur Keller Rinaudo began Zipline as a startup out of his apartment five years ago. Since then, the CEO has attracted some $41 million in investment, including from Google Ventures and the founders of Yahoo and Microsoft.
“I wanted to use technology to solve a real problem in the world—to help save lives,” he says.
The company, which includes aerospace experts from SpaceX, Boeing, and NASA, has designed, built, and optimized all its own drones, autonomous software, and launch and landing systems, and some of its inventions are already being employed by other big players. Zipline settled on a fixed-wing, battery-operated model that can carry a payload of 4 pounds (1.8 kilos), with a 50-mile (80-kilometer) range, flying at up to 70 miles an hour.
The firm expects to make about 600 flights a day, serving 12 million people, Rinaudo says. Even as we are talking, a request is being fulfilled in the packaging warehouse. One of 30 modular drones, loaded with the precious cargo and fresh batteries, is lined up on the launch shoot. It has a 10-foot (3-meter) wingspan, and it’s 5 feet long from nose to tail.
The aviation engineer, one of the company’s four members of the all-female crew of local Ghanaians, carries out final checks. Then she requests clearance from the Civil Aviation Authority before launching the drone into the skies. Doing away with the rotors needed for takeoff and landing dramatically reduces the onboard power requirements, allowing for lighter batteries.
If the launch is exciting, the landing is extraordinary. Two metal A-frames, suspending a thin wire between their apexes, have to capture the drone midflight. Success looks improbable. And yet the incoming drone steers itself so that as it zooms down, the small hook on its tail snags the wire. There it rests, hanging nose-down until its next mission. The drone can operate in all weather conditions, barring strong winds, the team says.
For nurses like Tetteh, the service is a lifeline for her community. “When a mother is in labor, she expects us to save her,” she says. “We do not wish to be too late for that.”
MIT Technology Review reimbursed GAVI for the costs of Gaia's trip.